In connection with the treatment of the cardiac rhythm disorder, different authors (Hochleitner, Bekker, Cazeau) have proposed to treat with the help of stimulation myocardial contraction disturbances observed in patients with cardiac insufficiency, which disturbances are spontaneous or induced by a traditional stimulation.
Indeed, one has observed that patients presenting class NYHA 3 and 4 disturbances could see their condition improved by an appropriate stimulation. It has been particularly proposed, in a first experience, to use a conventional double-chamber pacemaker by programming a short atrio-ventricular delay ("AVD"). In more recent studies, it has been proposed to stimulate right and left cavities in a triple chamber or quadruple chamber mode.
But, in all cases, no criterion of implantation has ever been clearly defined (except the criterion of a cardiac insufficiency). Nor has there been an explanation of the mechanisms implied in the correction of those cardiac disturbances. The programming of the different stimulation parameters is, therefore, in the current knowledge state, individualized for each patient and by each therapist.